I. See Also

II. Indications

III. Pathophysiology

  1. Second Generation Antihistamine

IV. Advantages

  1. Fexofenadine (Allegra)
    1. Least sedating, even in higher doses
  2. Loratadine (Claritin)
    1. Sedating at higher doses
    2. Less potent than Allegra and Zyrtec
  3. Cetirizine (Zyrtec)
    1. May be sedating even at normally recommended doses

V. Disadvantages

  1. Expensive!

VI. Preparations: Oral

  1. Fexofenadine (Allegra, Tabs 30-60-180 mg, Dissolving 30 mg, Suspension 30 mg/5ml)
    1. Adult Dose (ages 12 and over): 60 mg orally twice daily or 180 mg orally daily
    2. Child Dose (ages 6-11 years): 30 mg orally twice daily
    3. Low Sedation and highly effective
  2. Loratadine (Claritin, OTC, tabs 10 mg, Dissolving 5-10 mg, Syrup 1mg/ml)
    1. Adult Dose (ages 6 and over): 10 mg orally daily
    2. Child Dose (ages 2-5 years): 5 mg orally daily
  3. Desloratadine (Clarinex, tabs 5 mg, Dissolving 2.5-5 mg, Syrup 0.5 mg/ml)
    1. Adult Dose (ages 12 and over): 5 orally daily
    2. Child Dose (ages 6-11 years): 2.5 mg orally daily to twice daily
    3. Preschool Dose (ages 12 months to 5 years): 1.25 mg orally daily
    4. Infant Dose (ages 6-12 months): 1 mg orally daily
  4. Cetirizine (Zyrtec, OTC, Tabs or Chewables 5-10 mg, Syrup 5 mg/5 ml)
    1. Adult Dose (includes ages 6-11): 5 or 10 mg orally daily
    2. Child Dose (ages 2-5 years): 2.5 mg orally daily to twice daily
    3. Infant Dose (ages 6 months to 2 years): 2.5 mg orally daily
  5. Levocetirizine (Xyzal, Scored Tabs 5 mg, solution 2.5 mg/5ml)
    1. Adult Dose (ages 12 and over): 5 mg orally daily
    2. Child Dose (ages 6-11 years): 2.5 mg orally daily

VII. Preparations: Nasal

  1. Azelastine (Astelin) 1-2 sprays per nostril twice daily (ages 5 and over)
  2. Olopatadine (Patanol) 2 sprays per nostril twice daily (ages 12 and over)

VIII. Pregnancy and Lactation

  1. Claritin is pregnancy Class B
    1. Other meds are Class C or unknown
  2. Contraindicated in Lactation

IX. Drug Interactions

  1. Astemizole (Hismanal) and Terfenadine (Seldane)
    1. Prolong QT Interval
    2. Contraindicated with Erythromycin, Ketoconazole
    3. Resulted in fatal arrhythmias in multiple cases

X. References

Images: Related links to external sites (from Google)

Cost: Medications

LORATADINE (on 2/10/2012 at Target.com)
LORATADINE 10 MG Tablet #30 for $4.00 ($0.13/unit)
Loratadine (on 2/9/2012 at DrugStore.com)
Loratadine 10mg Tablets #30 for $21.99 ($0.73/unit)
Claritin (on 2/9/2012 at DrugStore.com)
Claritin 10mg Tablets #30 for $35.99 ($1.20/unit)
Claritin 30 10mg Tablets Box #1 for $32.55 ($32.55/unit)
Cetirizine-Pseudoephedrine (on 2/9/2012 at DrugStore.com)
Cetirizine-Pseudoephedrine 24 5-120mg 12 Hour Tablets Box #1 for $36.99 ($36.99/unit)
Levocetirizine Dihydrochloride (on 2/9/2012 at DrugStore.com)
Levocetirizine Dihydrochloride 5mg Tablets #30 for $89.99 ($3.00/unit)
Cetirizine HCl (on 2/9/2012 at DrugStore.com)
Cetirizine HCl 10mg Tablets #100 for $18.99 ($0.19/unit)
Cetirizine HCl 100 5mg Tablets Bottle #1 for $99.99 ($99.99/unit)
Cetirizine HCl Childrens Alrgy (on 2/9/2012 at DrugStore.com)
Cetirizine HCl Childrens Alrgy 1mg/ml Syrup 118ml Bottle #1 for $15.99 ($15.99/unit)
ZyrTEC-D Allergy & Congestion (on 2/9/2012 at DrugStore.com)
ZyrTEC-D Allergy & Congestion 12 5-120mg 12 Hour Tablets Box #1 for $22.99 ($22.99/unit)
Fexofenadine HCl (on 2/9/2012 at DrugStore.com)
Fexofenadine HCl 60mg Tablets #30 for $26.99 ($0.90/unit)
Fexofenadine HCl 180mg Tablets #30 for $25.99 ($0.87/unit)
Fexofenadine-Pseudoephedrine (on 2/9/2012 at DrugStore.com)
Fexofenadine-Pseudoephedrine 180-240mg 24 Hour Tablets #30 for $139.98 ($4.67/unit)
Allegra-D 12 Hour (on 2/9/2012 at DrugStore.com)
Allegra-D 12 Hour 60-120mg 12 Hour Tablets #30 for $81.57 ($2.72/unit)
Allegra (on 2/9/2012 at DrugStore.com)
Allegra 60mg Tablets #60 for $98.99 ($1.65/unit)
Allegra Allergy (on 2/9/2012 at DrugStore.com)
Allegra Allergy 30 180mg Tablets Bottle #1 for $28.99 ($28.99/unit)
Allegra Allergy 45 180mg Tablets Bottle #1 for $32.99 ($32.99/unit)
Allegra Allergy 12 60mg Tablets Box #1 for $19.99 ($19.99/unit)
Allegra-D Allergy & Congestion (on 2/9/2012 at DrugStore.com)
Allegra-D Allergy & Congestion 20 60-120mg 12 Hour Tablets Box #1 for $25.99 ($25.99/unit)
Allegra-D Allergy & Congestion 10 180-240mg 24 Hour Tablets Box #1 for $26.99 ($26.99/unit)
Allegra Allergy Childrens (on 2/9/2012 at DrugStore.com)
Allegra Allergy Childrens 30mg/5ml Suspension 120ml Bottle #1 for $20.99 ($20.99/unit)

Ontology: Cetirizine (C0055147)

Definition (MSH) A potent second-generation histamine H1 antagonist that is effective in the treatment of allergic rhinitis, chronic urticaria, and pollen-induced asthma. Unlike many traditional antihistamines, it does not cause drowsiness or anticholinergic side effects.
Definition (NCI) Cetirizine is a metabolite of hydroxyzine and a selective peripheral histamine H1-receptor antagonist. It is used for symptomatic treatment of seasonal and perennial allergic rhinitis and for chronic urticaria. (NCI)
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D017332
SnomedCT 108655000, 372523007
English Cetirizine, (2-(4-((4-Chlorophenyl)phenylmethyl)-1-piperazinyl)ethoxy)acetic Acid, Acetic acid, (2-(4-((4-chlorophenyl)phenylmethyl)-1-piperazinyl)ethoxy)-, cetirizine, CETIRIZINE, Cetirizine [Chemical/Ingredient], Cetirizine (product), Cetirizine (substance)
Swedish Cetirizin
Czech cetirizin
Finnish Setiritsiini
Russian TSETIRIZIN, ЦЕТИРИЗИН
Japanese セチリジン, セテリジン
Polish Cetyryzyna
Spanish cetiricina, cetirizina (producto), cetirizina (sustancia), cetirizina, Cetirizina
French Cétirizine
German Cetirizin
Italian Cetirizina
Portuguese Cetirizina

Ontology: Loratadine (C0065180)

Definition (MSH) A second-generation histamine H1 receptor antagonist used in the treatment of allergic rhinitis and urticaria. Unlike most classical antihistamines (HISTAMINE H1 ANTAGONISTS) it lacks central nervous system depressing effects such as drowsiness.
Definition (NCI) A piperidine histamine H1-receptor antagonist with anti-allergic properties and without sedative effects. Loratadine blocks the H1 histamine receptor and prevents the symptoms that are caused by histamine activity on capillaries, bronchial smooth muscle, and gastrointestinal smooth muscle, including vasodilatation, increased capillary permeability, bronchoconstriction, and spasmodic contraction of gastrointestinal smooth muscle. Loratadine does not cross the blood-brain barrier and does not cause central nervous system effects.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D017336
SnomedCT 108652002, 386884002
English Loratadine, 4-(8-Chloro-5,6-dihydro-11H-benzo(5,6)cyclohepta(1,2-b)pyridin-11-ylidene)-1-piperidinecarboxylic Acid Ethyl Ester, 1-Piperidinecarboxylic acid, 4-(8-chloro-5,6-dihydro-11H-benzo(5,6)cyclohepta(1,2-b)pyridin-11-ylidene)-, ethyl ester, loratadine (medication), 1-Piperidinecarboxylic acid, 4-(8-chloro-5,6-dihydro-11H-benzo(5,6)cyclohepta(1,2-b)pyridin-11-ylidene)-, Ethyl Ester, loratadine, LORATADINE, Loratadine [Chemical/Ingredient], Loratadine product, Loratadine (product), Loratadine (substance)
Swedish Loratadin
Czech loratadin
Finnish Loratadiini
Russian LORATADIN, ЛОРАТАДИН
Japanese ロラタジン
Polish Loratadyna
Spanish loratadina (producto), loratadina (sustancia), loratadina, Loratadina
French Loratadine
German Loratadin
Italian Loratadina
Portuguese Loratadina

Ontology: Zyrtec (C0162723)

Definition (CHV) brand name of an allergy medicine
Definition (CHV) brand name of an allergy medicine
Definition (CHV) brand name of an allergy medicine
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D017332
English Zirtek, zyrtec [brand name], zirtek, zyrtec, ZyrTEC, Zyrtec, Pfizer Brand of Cetirizine Dihydrochloride, Pfizer Consumer Healthcare Brand of Cetirizine Dihydrochloride, Reactine, UCB Brand of Cetirizine Dihydrochloride, UCB Pharma Brand of Cetirizine Dihydrochloride, United Drug Brand of Cetirizine Dihydrochloride, Voltric

Ontology: fexofenadine (C0296800)

Definition (NCI) A drug used to treat certain allergy symptoms. It blocks a chemical released during an allergic response that causes itching, sneezing, runny nose, wheezing, and watery eyes. It is a type of antihistamine.
Definition (NCI) A second generation, long-lasting selective histamine H1 receptor antagonist with antiinflammatory property. Fexofenadine is a highly selective and reversible competitor at peripheral H1 histamine receptors in the gastrointestinal (GI) tract, blood vessels, and bronchial smooth muscle. This agent interferes with mediators release from mast cells either by inhibiting calcium ion influx across mast cell/basophil plasma membrane or by inhibiting intracellular calcium ion release within the cells. In addition fexofenadine may also inhibit the late-phase allergic reaction by acting on leukotrienes or prostaglandins, or by producing an anti-platelet activating factor effect. Overall, this agent blocks the actions of endogenous histamine, thereby leads to temporary relief of the negative symptoms associated with histamine and achieve effects such as decreased vascular permeability, reduction of pruritus and localized smooth muscle relaxation.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH C093230
SnomedCT 108650005, 372522002
English alpha-(4-(1-carboxy-1-methylethyl)phenyl)-4-hydroxydiphenylmethyl-1-piperidinebutanol, fexofenadine, fexofenadines (medication), fexofenadines, FEXOFENADINE, fexofenadine [Chemical/Ingredient], Fexofenadine, Fexofenadine (substance), Fexofenadine (product)
Spanish fexofenadina (producto), fexofenadina (sustancia), fexofenadina

Ontology: Claritin (C0701055)

Definition (CHV) brand name of loratadine
Definition (CHV) brand name of loratadine
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D017336
English claritin, claritin [brand name], Claritin

Ontology: Allegra (C1110594)

Definition (CHV) brand name of an allergy medicine
Definition (CHV) brand name of an allergy medicine
Definition (NCI) A drug used to treat certain allergy symptoms. It blocks a chemical released during an allergic response that causes itching, sneezing, runny nose, wheezing, and watery eyes. It is a type of antihistamine.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH C093230
English Telfast, telfast, allegra, allegra [brand name], Aventis Behring brand of fexofenadine hydrochloride, Aventis Pharma brand of fexofenadine hydrochloride, Aventis brand of fexofenadine hydrochloride, Hoechst brand of fexofenadine hydrochloride, Allegra

Ontology: Histamine H1 Antagonists, Non-Sedating (C1136312)

Definition (MSH) A class of non-sedating drugs that bind to but do not activate histamine receptors (DRUG INVERSE AGONISM), thereby blocking the actions of histamine or histamine agonists. These antihistamines represent a heterogenous group of compounds with differing chemical structures, adverse effects, distribution, and metabolism. Compared to the early (first generation) antihistamines, these non-sedating antihistamines have greater receptor specificity, lower penetration of BLOOD-BRAIN BARRIER, and are less likely to cause drowsiness or psychomotor impairment.
Concepts Pharmacologic Substance (T121)
MSH D039563
SnomedCT 349956006, 372624008
French Anti-histaminiques H1 non sédatifs, Antihistaminiques de seconde génération, Anti-histaminiques de seconde génération, Antagonistes de l'histamine H1 non sédatifs, Antihistaminiques H1 non sédatifs
Swedish Histamin H1-blockerare, icke-sederande
English HISTAMINE H1 ANTAG NON SEDATING, HISTAMINE ANTAGONISTS H 001 NON SEDATING, antihistamines non sedating, non-sedating antihistamine, second generation antihistamine, antihistamines second generation, antihistamine non sedating, second generation antihistamines, Antihistamines, Second Generation, H1 Antihistamines, Non Sedating, H1 Antihistamines, Non-Sedating, Histamine H1 Antagonists, Non Sedating, Histamine H1 Antagonists, Non-Sedating, Non-Sedating H1 Antihistamines, Second Generation Antihistamines, Second Generation H1 Antagonists, Non-sedating antihistamine, Non-sedating antihistamine (product), Non-sedating antihistamine (substance), Histamine1 (H1) Blocking Agents, Mildly/Non-sedating
Czech histaminové H1-receptory - blokátory nesedativní, histamin H1 - antagonisté nesedativní
Finnish Väsyttämättömät antihistamiinit
German H1-Antagonisten der zweiten Generation, HISTAMIN ANTAGONISTS H 001 NICHT SEDIERENDE, Histamin-H1-Antagonisten, nicht sedierende
Russian GISTAMINA H1 ANTAGONISTY NESEDATIVNYE, ГИСТАМИНА H1 АНТАГОНИСТЫ НЕСЕДАТИВНЫЕ
Japanese 非鎮静性ヒスタミンH1拮抗剤, 非鎮静性H1抗ヒスタミンザイ, H1抗ヒスタミンザイ-非鎮静性, ヒスタミンH1拮抗剤-非鎮静性
Polish Antagoniści histaminy H1 bez działania uspokajającego, Antyhistaminiki H1 II generacji, Leki antyhistaminowe H1 II generacji, Leki przeciwhistaminowe H1 II generacji
Spanish antihistamínico no sedante (producto), antihistamínico no sedante (sustancia), antihistamínico no sedante, Antagonistas de Histamina H1 no-Sedantes
Italian Antagonisti dell'istamina H1, non sedativi
Portuguese Antagonistas da Histamina H1 não Sedantes, Antagonistas da Histamina H1 não Sedativos